The goal of the proposed research is to develop computerized radiographic methods for measuring bone structure for use in quantitatively assessing osteoporosis and risk of fracture. We will investigate the characteristics of trabecular bone structure in digital radiographs in the spine, hip and extremities using computerized texture analyses. We believe that our methods have the potential to aid in the assessment of osteoporosis and that the use of both BMD and bone structure information should improve the predictive value for assessing fracture risk over that obtainable with BMD alone. We will create a database in order to quantify the characteristic features of the trabecular pattern in high-resolution radiographic bone images of patients with varying degrees of osteoporosis, as well as in normal subjects. Specifically, we plan to (l) develop computerized texture analysis schemes for the automatic assessment of bone structure in digitized bone radiographs, (2) investigate the effects of various parameters of the image acquisition system, as well as of the analysis schemes themselves, on performance and (3) evaluate the efficacies of the computerized schemes in predicting risk of fracture as compared to a current method of measurement [dual-energy x-ray absorptiometry (DXA)] using a large clinical database. Methods that are capable of analyzing bone structure of trabeculae, along with bone mass measures, are expected to give additional insight to the evaluation of osteoporosis and risk of fracture. Our scheme is unique in that it attempts to quantify automatically the risk of fracture from texture analyses (Fourier analysis, multi-fractal analysis, gradient analysis and artificial neural networks) of the bone trabecular pattern as present in high-resolution radiographs of the spine, hip and extremities. The potential significance of this research project lies in the fact that if the detection of high-risk patients could be accomplished with a reliable, low-dose, economical system, then screening for osteoporosis could be implemented more broadly, thereby allowing earlier treatment and a reduction in the risk of fracture.